Ava Magdalene Charboneau, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2080 Century Park E Ste 710
Los Angeles, CA 90067-2010

Phone

(310) 715-3237

NPI assigned

Feb 12, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Innovative Medical Solutions Inc a Medical Group

  • Adolescent Medicine (Internal Medicine) Physician
  • Panorama City, CA
  • NPI 1972624955

  CA

  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752364800000",
    "number": "1497560668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E STE 710",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672010",
            "telephone_number": "206-914-6892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E STE 710",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672010",
            "telephone_number": "310-715-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARBONEAU",
        "first_name": "AVA",
        "middle_name": "MAGDALENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-07-13",
        "certification_date": "2025-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebony Chappell
• Renee Chappell
• Shanna L Chappell
• William T Chappelle
• Cynthia Chapula
• Steven M Charbonnet, PHYSICAL THERAPY
• Nestor Fernando Charcape
• Rena Boyajian Charchian, PHARM.D.
• Sanaz Sunny Charchian
• Alisa Charee

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.